Guttural Pouch Disorders

...and on the eighth day God created the horse in perfect image, to romp, graze, gallop, play and make manure wherever it darn well pleases, in divine grace.

The large mucous sacs that open up off of the auditory, or eustachian tube, are called “Guttural Pouches.” Located below and between the base of the skull and the first vertebra, and above the pharynx. (1)

Infection or pharyngitis, inflammation of the pharynx, can cause pus formation in the Guttural Pouches, since the pharynx connects to the eustachian tube. Infection can spread to the eustachian tube and go beyond into the lining of one or both Guttural Pouches. Infection can also be secondary to other upper respiratory diseases, such as the bacterial infection, “Strangles.”

Strangles is horse distemper, as a result from Streptococcus Equi.

Other complications can result from infection in a cascade, as pus forms in the Guttural Pouch .

“Chondroids,” solid, cheese-like masses that are shaped by the pus and mucous, thicken and dry out within the Guttural Pouch. (2)

Where there is pus, there is infection. Chondroids can indicate a longer time frame of ongoing infection and pus and Chondroid material can discharge from the nostrils of the animal. Sometimes there is blood within the pus.

Nosebleeds can indicate a fungal infection of the Guttural Pouch. (4)

Sometimes there is a painless swelling located just behind the jaw and below the ear, at the Parotid Gland, and when this has pressure applied, nasal discharge is expressed.

If the horse shakes or lowers its head, more nasal discharge comes out.

Another condition of the eustachian tube, which could be considered a congenital defect, (present at birth) is called “Tympany,” an accumulation of air within the Guttural Pouch itself. Inflammation in the area may also cause Tympany. (3)

A small fold of mucous membrane positioned at the opening of the Guttural Pouch behaves in a valve-like manner and keeps air from exiting the Pouch after it has come in during respiration, thus causing Tympany.

Signs of Tympany, in the same area of the lower ear and behind the jaw, are a large painless swelling of the Paratoid Salivary Gland. (4) This causes the horse to have difficulty breathing and can be seen standing with its neck and head extended.

Eating can result in bouts of coughing, with finite pieces of hay and grain discharging from the nostrils.

A Veterinarian can diagnose this condition and aspirate the swelled area. It is a lot more complicated than simply lancing an abscess. When the area is aspirated, air can come out quite explosively, thus indicating that there is considerable pressure in the pharynx and eustachian tube, which causes difficulty with swallowing and breathing. (5)

The horse can look as if it has mumps with this condition, with the swelling located in the throatlatch and lower cheek area.

Diagnoses involving the Guttural Pouch usually require surgery by the Vet. It’s tricky, since several cranial nerves and the carotid, or main artery of the neck, are right adjacent to the Guttural Pouches and can very easily be injured. The Pouch must be catheterized and flushed with antibiotics and sterile saline solution. Don’t try this at home. (6)

Of course, the Vet will have to identify the underlying cause of the infection.

The surgery of Chondroids and Tympany require that the Guttural Pouch area be opened and examined. All fluid and Chondroid masses are removed, thus allowing the Pouch to drain.

The Guttural Pouch is then flushed several times a day with an antibiotic mixture until it is healed.

Air may still accumulate again, if the membranous flap is not removed. The Vet will have to come back and perform a surgical removal of the flap, thus allowing air to pass freely during respiration, between the eustachian tube and the Guttural Pouch. (7)

Always call the Vet in event of Strangles or disorders or the Guttural Pouch.

Thought I’d gross you out just in time for Christmas. Don’t read this article over lunch while having...well never mind, wouldn’t want to ruin anything.

Thank you all once again for reading Horsin’ Around. Have Ol' Saint Nick give your buddy some peppermints in his grain bin and keep those troughs and water buckets clean of debris and ice.

Have a wonderful Christmas and a great New Year, we'll talk soon.

Leaving you with the sound of Cardinal birds and sleigh bells in the lane, to the immortal words of Roy Rogers and Dale Evans, “Happy Trails to You.”

1-7: “Horseman’s Veterinary Encyclopedia,” by Will A. Hadden, DVM